title: Serum uric acid level and endothelial dysfunction in patients with nondiabetic chronic kidney disease.
abstract: BACKGROUND
  An elevated serum uric acid level is strongly associated with endothelial dysfunction and inflammation, both of which are common in chronic kidney disease (CKD). We hypothesized that endothelial dysfunction in subjects with CKD would correlate with uric acid levels.
  
  
  METHODS
  We evaluated the association between serum uric acid level and ultrasonographic flow-mediated dilatation (FMD) in 263 of 486 patients with recently diagnosed CKD (stage 3-5) (48% male, age 52 ± 12 years). To minimize confounding, 233 patients were excluded because they were diabetic, had established cardiovascular complications or were taking drugs (renin-angiotensin system blockers, statins) interfering with vascular function.
  
  
  RESULTS
  Serum uric acid level was significantly increased in all stages of CKD and strongly correlated with estimated glomerular filtration rate (eGFR-MDRD); FMD was inversely associated with serum uric acid (r = -0.49, p < 0.001). The association of serum uric acid with FMD remained after adjustment for age, gender, smoking, LDL cholesterol, eGFR, high-sensitivity C-reactive protein, systolic blood pressure, proteinuria, and homeostatic model assessment index (β = -0.27, p < 0.001).
  
  
  CONCLUSIONS
  Increased serum uric acid is an independent predictor of endothelial dysfunction in subjects with CKD.
authors.affiliation: Division of Nephrology, Gulhane School of Medicine, Ankara, Turkey. drkanbay@yahoo.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
authors.forename: Mahmut Ilker
authors.initials: MI
authors.lastname: Yilmaz
authors.forename: Alper
authors.initials: A
authors.lastname: Sonmez
authors.forename: Faruk
authors.initials: F
authors.lastname: Turgut
authors.forename: Mutlu
authors.initials: M
authors.lastname: Saglam
authors.forename: Erdinc
authors.initials: E
authors.lastname: Cakir
authors.forename: Mujdat
authors.initials: M
authors.lastname: Yenicesu
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: Diana
authors.initials: D
authors.lastname: Jalal
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Johnson
mesh_terms: D000328:Adult; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000096:biosynthesis; D008078:Cholesterol, LDL / Q000378:metabolism; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000378:metabolism; D012907:Smoking; D014463:Ultrasonography / Q000379:methods; D014527:Uric Acid / Q000097:blood*; D014652:Vascular Diseases / Q000150:complications*
chemical_list: D008078:Cholesterol, LDL; D014527:Uric Acid; D002097:C-Reactive Protein